| NPI | 1073635264 |
|---|---|
| Doing Business As | BRIGHTON MARINE PHY AT HANSCOM |
| Entity Type | Organization |
| Authorized Contact | JAMES GERMANO Pharmacy Manager 617-562-5302 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0002X Pharmacy, Clinic Pharmacy (Licence: MA MA0042870) |
| Additional Taxonomies | 3336C0002X Pharmacy, Clinic Pharmacy |
| 3336M0003X Pharmacy, Managed Care Organization Pharmacy | |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2007-10-24 |